PrEP Flashcards
(4 cards)
1
Q
PrEP indication
A
- MSM: on-demand or daily oral TD-FTC should be offered to HIV-negative MSM who are identified as being at elevated risk of HIV acquisition through condomless anal sex in the previous 6 months and ongoing condomless anal sex
- Also MSM having condomless anal sex with partners who are HIV positive, unless the partner has been on ART for at least 6 months and their plasma viral load is <200 copies/mL.
- HIV-negative heterosexual men and women having condomless sex with partners who are HIV positive, unless the partner has been on ART for at least 6 months and their plasma viral load is <200 copies/mL
- NOT routinely recommended for PWID. Case by case if high risk.
- Trans people - same as heterosexuals - recommended if partner HIV positive, case by case in high risk.
2
Q
PrEP when to start
A
- If the risk of HIV acquisition is through anal sex, PrEP can be started with a double dose of TD-FTC taken 2–24 hours before sex and continued daily until 48 hours after the last sexual risk.
We recommend that if PrEP for anal sex has been interrupted and it is less than 7 days since the last TDFTC dose then PrEP can be re-started with a single dose of TD-FTC.
We recommend that if the risk of HIV acquisition is through vaginal sex, PrEP should be started as a daily regimen 7 days ahead of the likely risk and continued daily for 7 days after the last sexual risk.
3
Q
Baseline testing in PrEP
A
- Baseline HIV serology (3rd gen plus)
- Same day PrEP if negative serology in past 4 weeks and no exposure
- HIV PCR if high risk exposure in the last 4 weeks
- HBV screening
- Baseline HCV screening
- Full STI screen including triple site swabs
- Creat and eGFR
4
Q
Monitoring whilst on PrEP
A
- HIV serology every 3 months
- 3 monthly STI screen
- 3 monthly HCV screening in high risk groups
- Renal monitoring yearly of baseline eGFR >90 and age < 40
- If eGFR 60-90 or age >40 or other risk factors, 6 monthly screen
